Daniel Esgardo Rangel Barón: Physician Tolerance and the Six Sigma Clinic

There’s a concept in manufacturing called tolerance. It’s the error allowed as part of the process of making stuff.

Engineering tolerance is the permissible limit or limits of variation in: a physical dimension; a measured value or physical property of a material, manufactured object, system, or service … — Wikipedia

In medicine patient care is increasingly process-centric and our tolerance is measured as quality. If administrators can master the process we achieve Six Sigma success.

This is good because there are places in medicine where six sigma reliability is essential (like cleaning sterile equipment). But despite our drive for clinical industrialization, there’s no algorithm that accounts for the imperfect human. Human variability just doesn’t work with algorithms.

So in a health system so focused on quality how will we tolerate the inconsistency and imperfection that someone like me brings to the table. I suspect we will tolerate this less and less. Within this generation, health care delivery will evolve as a series of algorithmic and machine-driven processes that will be more efficient and precise. With more tech-mediated diagnostics and therapeutics, concerns with physician tolerance will become a thing of the past.

Process improvement is key to quality care. And no sensible patient would want anything less. But I suspect over time patients will demand connection with imperfect humans. Be it for touch or deeper understanding, intermediation among the machines will define our unique value.

If you like this you might like our 33 charts Clinic Operations Archive.

Photo by Vladimir Fedotov on Unsplash


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